Since marijuana (cannabis) in different countries gradually acquires legal status and cultural recognition, questions about who may use the drug are becoming more relevant. Recently a large medical organization announced: marijuana use during pregnancy and breastfeeding to put it mildly,not a good idea. What is it and where did the topic of marijuana during pregnancy.
The American Academy of Pediatrics (AAP) officially recommends that pediatricians advise women to abstain from marijuana use during pregnancy and breastfeeding. Their recommendations are based on clinical report that addresses the small studies suggesting that this practice can potentially affect healthy growth and development of the fetus, infant or child. Co-author Seth Ammerman, MD, Professor, Department of adolescent medicine Department of Pediatrics Stanford University, comments on the results:
The main conclusion is that women should not use marijuana throughout pregnancy. There is limited evidence suggesting that it may cause adverse effects on the developing fetus and later in infancy and childhood.
AAP also recommends against the use of marijuana during breastfeeding. AAP conservative position coincides with the position of the American College of obstetricians and gynecologists (ACOG). ACOG advises pregnant women to avoid not only marijuana, but also the impact of smoke, due to the potential impact on neuroreplete, recognizing that it is difficult to judge the specific impact of marijuana on pregnancy and the developing fetus, partly because those who use it often use other drugs, including tobacco, alcohol, or illegal substances.
The main psychoactive component of cannabis, THC (tetrahydrocannabinol) can pass the placenta and breast milk
According to the AAP report, there are limited data showing that THC can get to the fetus (including animal studies, for example, on rats in 1989 and the monkey in 1987).
Proof that THC can enter the breast milk is the later and final. Therefore, if women use marijuana during pregnancy or while breastfeeding, there is the likelihood of the impact on the normal function and development of the fetus or infant. However, how this occurs and at what point it could affect the fetus, is not yet entirely clear.
There are several reasons why exposure to cannabis during pregnancy and breastfeeding can be more challenging than the impacts of other substances. Unlike alcohol, which is metabolized and excreted from the body relatively quickly, cannabinoids in marijuana (including THC) can stay in the body for several weeks after consumption.
The psychoactive components of marijuana are stored in maternal adipose tissue, and from there they are released into the bloodstream and thus potentially fall within the uterine environment or in breast milk. However, experts find it difficult to answer the question, as golgoth will be there and in what quantities, which also complicates the study of the influence of marijuana.
Existing research
There is increasing evidence that marijuana use during pregnancy may lead to adverse consequences, such as problems with attention, reduced cognitive function and IQ scores, and slower growth, which may not occur until childhood or adolescence.
In analyzing data from a National study on the prevention of birth defects for 2009, published in Epidemiology, has been analyzed the relationship between the consumption of prohibited substances (the period from conception to early pregnancy) and birth defects in 10 of 241 child with major congenital anomalies (with a control group of 4 967 infants without major congenital malformations), born between 1997 and 2003. The study showed that, apparently, there is a possible link between use of cannabis in this period of time and an increased risk of having a child with anencephaly, a severe birth defect in which the baby lacks the parts of the brain and skull.
But it is important to give specific figures. Of the 244 babies born with this defect in the study, only 12 were born to women who used cannabis vosstanovleny period. In addition, the researchers found no link between use of cannabis and 19 other types of congenital problems that they considered. Therefore, they concluded that in General, cannabis seems not associated with serious congenital anomalies.
On the other hand, the study of 2017, published in The Journal of Maternal-Fetal Neonatal Medicine, revealed no associations between exposure to cannabis and the adverse consequences to the health of both baby and child in early childhood. From 1867 preterm infants included in the study, 135были subjected to cannabis the womb. However, one limitation of this study is the fact that scientists have measured how often the women had used cannabis.
Because the drug is historically difficult to explore, there are limitations to all these studies. Wide differences in dosage, strength, time and frequency of use,of course, remain outside of laboratory conditions. Another potential weakness is the reliance on self-report, not the most accurate method, especially when we are talking about illegal substances because people can conceal how often and how much marijuana they use. In addition, women who use cannabis are more likely to use other substances such as alcohol and tobacco, which complicates the separation of the effects of cannabis from other substances.
For example, meta-обзорААР2016 year published in BMJ Open, which reviewed 24 studies have shown that infants subjected to prenatal exposure to marijuana had reduced birth weight and higher probability of hospitalization in the intensive care unit for newborns. However, the majority of studies included in this review do not rule out that women are using other substances (e.g. tobacco or alcohol).
Another meta-analysis, 2016 provided in the AAP report published in Obstetrics Gynecology, collected data from 31 studies of the relationship between marijuana use and negative consequences, including low birth weight, need for intensive care, spontaneous abortion and premature birth. The researchers found that cannabis use during pregnancy is associated with an increased risk of low birth weight and premature birth. However, after the adjustment of the mixing factors (e.g., joint use of tobacco), they found that the use of marijuana by the mother during pregnancy is an independent risk factor of adverse effects on neonatal development.
The effect of THC on decado still unknown
According to the AAP, limited data indicate that THC really gets into human milk, but there is no evidence of safety or videopokerenlinea marijuana during lactation. In principle, all we know is that THC can enter the body of the child with mother’s milk, but it is unknown where it might lead.
First, it is unclear how long THC stays in the milk. In one recent study published in Pediatrics in August, THC was detected in the breast milk of 34 out of the 54 samples of breast milk from 50 mothers who use cannabis, up to six days after consumption. It is also unclear how the effects of THC (or other compounds) can affect the baby. As noted by the CDC, data on the impact of marijuana on baby through breast-feeding is limited and controversial.
In a study published in Neurotoxicology and Teratology in 1990, it was discovered that exposure to marijuana through breast milk during the first month after birth appears to be associated with a decrease in the development of children’s motor activity at age one year. However, these women also used cannabis in early pregnancy, this factor could not be detached from the study.
Long-term effects of cannabis
Narratvie potential effects include problems with learning, behaviour, Executive functioning and attention. The difficulty lies in the fact that all of these problems occur much later in childhood.
For example, the AAP cites one study, published in 1995. In this study, since 1978, the researchers followed the children 84женщин who have used cannabis during pregnancy. It was discovered that regardless of tobacco and other drugs, the effects of marijuana has significant and pervasive effects that are noticeable in ditaot 4 years to adolescence (compared with standard criteria).
This may include problems with understanding language, memory and visual/perceptual function in the age of 6 years, as well as problems with attention, problem solving and analytical skills in age from 13 to 16 years. However, the study is relatively small and demonstrates a correlation, not causal-sledstvennaya.
Another major study of 606 children aged 10 years, published in the journal Neurotoxicology and Teratology in 2004, showed that the effects of marijuana on the fetus during the first trimester is associated with problems reading and spelling, low grades in school, as well as depression and anxiety.However, it is also unclear whether the influence of marijuana for symptoms of anxiety and depression, or are there other factors that played a role in the situation.
So, what nursing moms should know about marijuana use?
Until recently, the medical world was not able to study marijuana use, but because such States as Colorado, where marijuana is now legalized, scientists will be able to get the full picture. It is necessary to conduct more research to conclusively establish the impact of THC on infants during pregnancy and breastfeeding, and this takes time.
Meanwhile, experts agree that in the absence of better studies pregnant or nursing mothers should exercise caution to protect the health of their fetus or child. According to the AAP, and the CDC, ACOG and the Academy of breastfeeding (ABM), it is best not to use cannabis while breastfeeding.
At the moment, there is no safe amount of marijuana for pregnant and lactating mothers. In light of this fact, abstinence from marijuana is by far the most correct measure of security.
But, despite numerous recommendations about abstinence, some experts believe that at this point there’s not enough evidence to say that women who use cannabis should not breastfeed. That’s what the doctor says , Flaherman, a pediatrician in the UCSF Benioff Childrens Hospitals:
If the mother uses marijuana and breastfeeding, I would have first advised her to stop using marijuana and continue breastfeeding. But if she are unable to stop using marijuana, I would not advise her to stop breastfeeding because the benefits of breastfeeding are widely known, and risks of marijuana passed on through breast milk have not been studied.
Similar is the position of Dr. Ammerman mentioned above:
With limited evidence, we can conclude that the benefits of breastfeeding outweigh the potential adverse consequences of the possible effects of cannabis.
Laura M. Borgelt, Professor and assistant Dean in Salepharmacy and pharmaceutical science Skaggs at the University of California, also believes that the positive effects of breastfeeding, even if using marijuana outweigh the potential negative consequences of refusal from breast feeding.
However, not all will belong to that camp. Most doctors still believe that if the mother prefers to use marijuana, she should not breastfeed. As there is no evidence that breastfeeding protects infants from the neurological effects of Smoking marijuana.
Be sure to consult your doctor
Although the laws on substance use vary from country to country, from a medical point of view, complete transparency is still considered correct. Open communication with physicians helps ensure the best results for the health of pregnant women and their children. It is important to speak with your obstetrician and then pediatrician about the use of marijuana because it will help them to assess any problems that arise in the fetus or infant.
An honest conversation with your doctor regarding the use of cannabis (including reasons) will also help to develop the best plan to solve health problems. For example, if you use cannabis to combat the unpleasant side effects of pregnancy such as morning sickness, the doctor will help you find safe alternatives.
If you use cannabis you are struggling with stress, don’t be afraid to ask for help. Pregnancy and motherhood is stressful at times, but the doctor will be able to advise you on the legal bezopasnye ways to cope with stress.